Individual
COLLEEN AILEEN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
(207) 661-4630
Mailing address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
(207) 661-4630
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1302
ME
225XH1200X
Hand Occupational Therapist
0875
NH
225XH1200X
Hand Occupational Therapist
OT1302
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
098828
ANTHEM INDIV. # MAINE
ME
01
—
1309918Y0NH02
ANTHEM INDIV. # NH
NH
05
—
30414852
—
NH
01
—
611931000
DEPT OF LABOR FACILITY #
—
01
—
9984995
CIGNA GROUP #
—
01
—
AA79032
HARVARD PILGRIM GROUP #
—
01
—
RE8968
MEDICARE GROUP
NH
Enumeration date
08/19/2006
Last updated
04/07/2025
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